EH - Mobile Food Unit Application

Environmental Health Division of
Mobile Food Unit/Push Cart
Plan Review

Application for a Mobile Food Unit or Pushcart Permit

Applicant Information

Name of Unit or Cart:

Vehicle Tag:

Name of Applicant:

Phone:

Mailing Address:

Mailing Address Line 2:

City:

State: Value is not selected

Zip Code:

Manager/Person in Charge:

Email Address:

Phone:

Type of Permit: Value is not selected

Projected Start Date:

Information & Requirements

COMMISSARY INFORMATION: Note - Private residences cannot be used for commissary purposes. All units, when operating, must report daily to a food establishment or commissary approved by this department for supplies, cleaning, and servicing. A completed Commissary Agreement or Shared Use Agreement must be included with application before the plan review process can begin. (see flow chart of plan review process)

APPLICATION SUBMISSION REQUIREMENTS: (1) Proposed Menu (2) Scaled drawing of Unit (3) Manufacturer’s specification sheets for all proposed or existing food service equipment (4) Commissary approval form (5) Route update form.

Food Equipment Information

List all food service equipment and attach copies of manufacturer specification sheets for:

1. COLD STORAGE EQUIPMENT - Provide the total number of refrigerators and freezers on unit and total cubic- feet to keep food 41F or below. Multiple units will be required: one to work out of and one for storage. Menu may require more. (Only prepackaged beverages, cans/bottles, may be stored in coolers)

2. COOKING EQUIPMENT – Flat top grill, fryer, oven, convection/microwave, panini press, toaster

3. FIRE SUPPRESSION:

Is there a ventilation hood system installed? Value is not selected

If yes, is there a continuous flue with exhaust fan to the exterior of the truck? Value is not selected

Is there a fire extinguisher? Value is not selected

If yes, what type is it? (Check all that apply) Values are not selected

Note: An approved ventilation hood system with removable filters and exhaust fan is required over all fryers, flat top grills and cooking equipment to prevent grease build up. As a safety provision we recommend an LP-gas piping inspection be completed by NC Dept of Agriculture before a permit is issued. It is recommended that all gas line piping be installed underneath the floor to cooking equipment. See website https://www.ncmhtd.com/NCDACS/Standards/FoodTruck

4. HOT HOLDING FOOD AND BEVERAGE EQUIPMENT – steam table (Include # of wells), hot hold cabinet (specify: full or half doors), heat lamp, coffee urn, cambro unit. Cambro units may be used for transportation only, once on location, a plug in electric/gas steam table or hot hold unit shall be used to maintain food at least 135F.

5. UTENSIL/WAREWASHING EQUIPMENT (PUSH CART IF APPLICABLE):

Number of Compartments of Utensil sink: Value is not selected

Size of compartment (Length x Width x Depth) inches

Length:

Width:

Depth:

NOTE: Your largest utensil/pot/pan is required to fit in all the sink compartments.

Will utensils be washed during operating hours of the unit? Value is not selected

What type of Sanitization will be used? Value is not selected

NOTE: Drainboards for dirty and clean utensil areas are required. If the sink does not have drainboards, please indicate and label where the dirty and clean areas are located on the drawing.

6. HAND WASH SINK

At least 1 hand sink is required. (manufacturer specification sheet for the hand sink is required) NOTE: Custom- built sinks or using food pans may not be approved. Splash guards may be needed when there is less than 12 inches of separation from food, work or storage areas.

Have at least 1 required hand sink? Value is not selected

7. FRESH/POTABLE WATER TANK AND WATER PUMP (PUSH CART IF APPLICABLE)

Size (Length x Width x Depth) of Fresh Water Tank:

Length (inches):

Width (inches):

Depth (inches):

Capacity - gallons (minimum tank size is 30 gallons)

Construction Material:

Do you have an approved drinking water hose to fill fresh water tank? Value is not selected

How and where will approved drinking water hose be stored between uses?

Attached Product Specification Sheet for Water Pump. On demand pump is required.
At time of permitting, you may be asked to demonstrate ability to fill fresh water tank properly.

8. WASTE WATER TANK (PUSH CART IF APPLICABLE)

Length (inches):

Width (inches):

Depth (inches):

Capacity - gallons (Waste tank must be 15% larger than fresh water tank)

Construction Material:

Waste water outlet connection shall be lower than the water inlet to prevent possible contamination of the fresh water system.
The waste water outlet connection shall be a different size and type than the fresh water connection.

Is there a valve to drain plumbing lines for winterization? Value is not selected

At time of permitting, you may be asked to demonstrate discharge of waste water properly.

9. WATER HEATER (PUSH CART IF APPLICABLE)

Tankless or Storage Tank? Value is not selected

If Storage Tank type list Capacity (gallons) :

Recovery Rate:

Make:

Model Number:

(Manufacturers specification sheet is required for the hot water heater)

10. MOBILE FOOD UNIT FINISHES - MUST BE SMOOTH, NONABSORBENT AND EASILY CLEANABLE

Floors:

Base cove:

Walls:

Ceiling:

11. ELECTRICAL

Generator Manufacturer:

Generator Model:

NOTE: The generator shall be capable of powering all electrical items on the unit. See the wattage work sheet to help in sizing the generator. A generator or power inverter is required to maintain constant power to the refrigerators/freezers anytime food is transported.

How will refrigeration be maintained during transit?

Number of electrical outlets:

Are all electrical lines protected/shielded? Value is not selected

Are the lights shielded or shatterproof? Value is not selected

Does the unit have an Air Conditioner? Value is not selected

12. DRY STORAGE – Describe the number and location of shelving for:

Single service items (paper products: plates, cups, etc.):

Food (Bread, condiments, etc.):

Chemicals:

Employee Personal Items:

Uploads: Attach copies of manufacturer specification sheets, menu, and drawing of mobile food unit or pushcart

Upload Specification Sheets:

Mobile Food Units and Pushcarts: Menu Page

This page must be completed. A separate menu must also be submitted.

All produce must be washed at the Commissary, on the Unit or be purchased prewashed. Be sure to specify where (at Commissary or on unit) that the food will be thawed, cut/wash, assembled, cooked, cold/hot held, and reheated. Please use one row for each food item and include all beverages.

(*MENU ITEMS ARE SUBJECT TO APPROVAL AND MAY BE RESTRICTED*)

Menu Item 1

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 2

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 3

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 4

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 5

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 6

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 7

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 8

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 9

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 10

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 11

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 12

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 13

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 14

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 15

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 16

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 17

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 18

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 19

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 20

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 21

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 22

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 23

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 24

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 25

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 26

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 27

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 28

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 29

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 30

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 31

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 32

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 33

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 34

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 35

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 36

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 37

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 38

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 39

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

Menu Item 40

Food Item

Food Supplier or Source

Thawing How? Where?

Cut/Wash/Assemble Where?

Cooking How? Where?

Cold/Hot Holding How/Where?

Reheating How?

MOBILE UNIT FLOOR PLAN EXAMPLE

1. Utensil washing sink
2. Hand sink
3. Serving window/counter
4. POS/Drink station
5. Microwave/toaster
6. Flip-top prep refrigerator
7. Stainless steel work table
8. Hood System
9. Fryer

10. Griddle
11. Range
12. Reach-in refrigerator
13. Reach-in freezer
14. Fresh & waste water holding tanks
15. Propane tank & generator
16. Exhaust vents

Total Square Feet = 144
Fresh water = 30 gals
Waste water = 35 gals
Scale ¼” = 1’

WATTAGE WORKSHEET (OPTIONAL)

This work sheet is to assist the operator in calculating a minimum generator size to run all electrical tools or appliances when not connected to electrical power via a plug. Multiply the amps times the volts for each electrical tool and appliance to get the watts. Add all the watts together to get the size of the generator needed. These should include lights and the water heater. To ensure the generator will power everything on the Mobile Food Unit, turn everything on while unit is connected to the generator.

Tool or Appliance 1

Type of Tool or Appliance

Amps

Volts